Explainable ICD Coding via Entity Linking

Leonor Barreiros, Isabel Coutinho, Gonçalo Correia, Bruno Martins


Abstract
Clinical coding is a critical task in healthcare, although traditional methods for automating clinical coding may not provide sufficient explicit evidence for coders in production environments. This evidence is crucial, as medical coders have to make sure there exists at least one explicit passage in the input health record that justifies the attribution of a code. We therefore propose to reframe the task as an entity linking problem, in which each document is annotated with its set of codes and respective textual evidence, enabling better human-machine collaboration. By leveraging parameter-efficient fine-tuning of Large Language Models (LLMs), together with constrained decoding, we introduce three approaches to solve this problem that prove effective at disambiguating clinical mentions and that perform well in few-shot scenarios.
Anthology ID:
2025.cl4health-1.18
Volume:
Proceedings of the Second Workshop on Patient-Oriented Language Processing (CL4Health)
Month:
May
Year:
2025
Address:
Albuquerque, New Mexico
Editors:
Sophia Ananiadou, Dina Demner-Fushman, Deepak Gupta, Paul Thompson
Venues:
CL4Health | WS
SIG:
Publisher:
Association for Computational Linguistics
Note:
Pages:
219–227
Language:
URL:
https://preview.aclanthology.org/fix-sig-urls/2025.cl4health-1.18/
DOI:
Bibkey:
Cite (ACL):
Leonor Barreiros, Isabel Coutinho, Gonçalo Correia, and Bruno Martins. 2025. Explainable ICD Coding via Entity Linking. In Proceedings of the Second Workshop on Patient-Oriented Language Processing (CL4Health), pages 219–227, Albuquerque, New Mexico. Association for Computational Linguistics.
Cite (Informal):
Explainable ICD Coding via Entity Linking (Barreiros et al., CL4Health 2025)
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PDF:
https://preview.aclanthology.org/fix-sig-urls/2025.cl4health-1.18.pdf